Recent changes in the epidemiology of dental caries and advances in the development of new diagnostic measurement techniques have stimulated interest in improved methods of assessing change in dental caries status. Traditional methods for assessing change focus primarily on the development of new lesions at the cavitation level and incorporate incomplete information on the progression of existing cavitated lesions. A methodology to expand the clinical recording of dental caries in clinical studies is suggested which includes 1) both non-cavitated and cavitated lesions and 2) the surface area affected for existing restorations. New indices are proposed to estimate changes in the number of new lesions, the progression of existing lesions and the total change in caries status for a subject. The degree of improvement over the traditional DMFS index can be estimated directly. It is hoped that clinical studies of shorter duration or involving smaller numbers of participants will be possible.